共刺激分子CD40与白细胞介素4在嗜酸性粒细胞性胃肠炎患儿中的表达及临床意义

Expressions of costimulatory molecule CD40 and interleukin 4 in children with eosinophil gastroenteritis and their clinical significance

目的分析共刺激分子CD40与白细胞介素4(IL-4)在嗜酸性粒细胞性胃肠炎患儿中的表达及临床意义。方法选择80例嗜酸性粒细胞性胃肠炎患儿作为嗜酸性粒细胞性胃肠炎组,包括44例急性期患儿及36例缓解期患儿。并选择92例健康儿童作为对照组。检测所有研究对象的外周血CD40、IL-4水平及嗜酸性粒细胞计数,分析嗜酸性粒细胞性胃肠炎患儿CD40与IL-4水平的相关性。采用受试者工作特征曲线分析CD40、IL-4对嗜酸性粒细胞性胃肠炎患儿的诊断效能。结果嗜酸性粒细胞性胃肠炎组CD40、IL-4水平及嗜酸性粒细胞计数均高于对照组(均P<0.05)。急性期嗜酸性粒细胞性胃肠炎患儿CD40、IL-4水平及嗜酸性粒细胞计数高于缓解期患儿(均P<0.05)。嗜酸性粒细胞性胃肠炎患儿CD40和IL-4水平呈正相关(P<0.05)。CD40、IL-4、CD40联合IL-4诊断嗜酸性粒细胞性胃肠炎患儿的曲线下面积分别为0.843、0.795、0.882,敏感度分别为0.663、0.625、0.788,特异度分别为0.934、0.902、0.923。结论共刺激分子CD40、IL-4可能参与嗜酸性粒细胞性胃肠炎的发生、发展,测定CD40、IL-4水平或能够辅助此类疾病的诊断以及疾病活动情况的评估。

Objective To analyze the expressions of costimulatory molecule CD40 and interleukin 4(IL-4)in the children with eosinophil gastroenteritis and their clinical significance.Methods Eighty children with eosinophil gastroenteritis,including 44 children in acute stage and 36 children in remission stage,were enrolled as eosinophil gastroenteritis group.And 92 healthy children were selected as control group.The CD40 and IL-4 levels,as well as eosinophil count of the peripheral blood were measured in all objects,and the correlation of CD40 level with IL-4 level was analyzed in the children with eosinophil gastroenteritis.The diagnostic efficacy of CD40 and IL-4 for pediatric eosinophil gastroenteritis was analyzed by using receiver operating characteristic curve.Results The levels of CD40 and IL-4,as well as eosinophil count in the eosinophil gastroenteritis group were higher than those in the control group(all P<0.05).The eosinophil gastroenteritis children in acute stage obtained higher levels of CD40 and IL-4,and a higher eosinophil count as compared with the children in remission stage(all P<0.05).There was a positive correlation between CD40 and IL-4 levels in the children with eosinophil gastroenteritis(P<0.05).For the diagnosis of pediatric eosinophil gastroenteritis,the areas under the curve of CD40,IL-4,and CD40 combined with IL-4 were 0.843,0.795 and 0.882,with sensitivity of 0.663,0.625 and 0.788,as well as specificity of 0.934,0.902 and 0.923,respectively.Conclusion Costimulatory molecule CD40 and IL-4 may be involved in the occurrence and development of eosinophil gastroenteritis.The detection of CD40 and IL-4 levels probably exert an auxiliary effect on the diagnosis of such disease and the evaluation of disease activity.